Birth Preferences for _________

I will be using self-hypnosis to manage my birthing time and may not be immediately responsive to questions during pressure waves. Please wait until my pressure wave ends and my eyes open to converse. Or speak directly to my Birth Partner. Because of the high level of concentration, I request low lights and quiet voices.

I would appreciate being assigned a nurse who enjoys natural births.

Please refrain from any medical interventions not previously agreed upon. I am happy to discuss any measures which may be deemed medically necessary prior to their implementations.

Please no IV. A Saline-Lock is fine.

I would prefer intermittent monitoring.

Please do not offer pain medication or ask me if I am in any pain. I will ask if I need it.

I would appreciate a minimum of vaginal exams and do not want to be informed of my progress.

Would appreciate perineal massage to help reduce the risk of tearing/episiotomy. I do not want an episiotomy… but am willing to discuss its necessity should the occasion arise.

Please use a blanket (rather than towels) to dry off and clean the baby gently with.

Please allow me time (an hour or so) to get to know my baby before removing him from my chest for weight and measurement.

Please do not cut the umbilical cord until it has stopped pulsing.

I appreciate your patience in waiting for the placenta to detach naturally.